PMID- 31563254
OWN - NLM
STAT- MEDLINE
DCOM- 20200602
LR  - 20211204
IS  - 1524-4733 (Electronic)
IS  - 1098-3015 (Linking)
VI  - 22
IP  - 10
DP  - 2019 Oct
TI  - Cost-Effectiveness of Sacubitril/Valsartan in Germany: An Application of the 
      Efficiency Frontier.
PG  - 1119-1127
LID - S1098-3015(19)32258-2 [pii]
LID - 10.1016/j.jval.2019.06.007 [doi]
AB  - BACKGROUND: To assess the cost-effectiveness of new treatments in Germany, the 
      efficiency frontier (EF) method has been developed. We compared the 
      cost-effectiveness analysis using international standards and the German 
      methodology, using the heart failure drug sacubitril/valsartan as an example. 
      METHODS: A previously developed Markov model was adapted to include 4 treatment 
      options: no treatment, enalapril, candesartan, and sacubitril/valsartan. The 
      internationally used incremental cost-effectiveness ratio (ICER) was calculated, 
      as well as cost-effectiveness acceptability curves. Additionally, EFs, net 
      monetary benefits (NMBs), and price-acceptability curves were created according 
      to German guidelines. All analyses were performed from the perspective of the 
      German Statutory Health Insurance. RESULTS: The base-case ICER for 
      sacubitril/valsartan compared to enalapril is euro19  300/quality-adjusted 
      life-year. On the cost-effectiveness acceptability curve, sacubitril/valsartan is 
      most likely to be cost-effective, out of all included comparators, from a 
      hypothetical willingness-to-pay threshold of euro18 250/quality-adjusted life-year 
      onward. No EF could be constructed for the base case. Taking the uncertainty of 
      the input parameters into account for the probabilistic sensitivity analysis, a 
      NMB of around -euro14 000 was calculated, depending on the outcome considered, with 
      the NMB being zero at a daily price for sacubitril/valsartan ranging from euro1.52 
      to euro1.67. CONCLUSION: We calculated an ICER for Germany, comparable to previously 
      published cost-effectiveness analyses for Europe, which widely concluded 
      sacubitril/valsartan to be cost-effective. Using the German EF approach, a 
      considerable discount needs to be applied before sacubitril/valsartan can be 
      considered cost-effective.
CI  - Copyright (c) 2019 ISPOR-The Professional Society for Health Economics and Outcomes 
      Research. Published by Elsevier Inc. All rights reserved.
FAU - van der Pol, Simon
AU  - van der Pol S
AD  - Department of Health Sciences, University Medical Center Groningen, University of 
      Groningen, Groningen, The Netherlands. Electronic address: s.van.der.pol@rug.nl.
FAU - de Jong, Lisa A
AU  - de Jong LA
AD  - Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The 
      Netherlands.
FAU - Vemer, Pepijn
AU  - Vemer P
AD  - Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The 
      Netherlands; Department of Epidemiology, University Medical Center Groningen, 
      University of Groningen, Groningen, The Netherlands.
FAU - Jansen, Danielle E M C
AU  - Jansen DEMC
AD  - Department of Health Sciences, University Medical Center Groningen, University of 
      Groningen, Groningen, The Netherlands; Department of Sociology, Interuniversity 
      Center for Social Science Theory and Methodology (ICS), University of Groningen, 
      Groningen, The Netherlands.
FAU - Postma, Maarten J
AU  - Postma MJ
AD  - Department of Health Sciences, University Medical Center Groningen, University of 
      Groningen, Groningen, The Netherlands; Groningen Research Institute of Pharmacy, 
      University of Groningen, Groningen, The Netherlands; Institute of Science in 
      Healthy Aging and Healthcare (SHARE), University Medical Center Groningen, 
      University of Groningen, Groningen, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20190806
PL  - United States
TA  - Value Health
JT  - Value in health : the journal of the International Society for Pharmacoeconomics 
      and Outcomes Research
JID - 100883818
RN  - 0 (Aminobutyrates)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Biphenyl Compounds)
RN  - 0 (Drug Combinations)
RN  - 0 (Tetrazoles)
RN  - 80M03YXJ7I (Valsartan)
RN  - WB8FT61183 (sacubitril and valsartan sodium hydrate drug combination)
SB  - IM
CIN - Value Health. 2020 May;23(5):674-675. PMID: 32389234
CIN - Value Health. 2020 May;23(5):675-676. PMID: 32389235
MH  - Aminobutyrates/administration & dosage/*economics
MH  - Angiotensin Receptor Antagonists/*economics
MH  - Biphenyl Compounds
MH  - *Cost-Benefit Analysis
MH  - Drug Combinations
MH  - Germany
MH  - Heart Failure/drug therapy
MH  - Humans
MH  - Tetrazoles/administration & dosage/*economics
MH  - Treatment Outcome
MH  - Valsartan
OTO - NOTNLM
OT  - efficiency frontier approach
EDAT- 2019/09/30 06:00
MHDA- 2020/06/03 06:00
CRDT- 2019/09/30 06:00
PHST- 2018/11/02 00:00 [received]
PHST- 2019/04/07 00:00 [revised]
PHST- 2019/06/19 00:00 [accepted]
PHST- 2019/09/30 06:00 [entrez]
PHST- 2019/09/30 06:00 [pubmed]
PHST- 2020/06/03 06:00 [medline]
AID - S1098-3015(19)32258-2 [pii]
AID - 10.1016/j.jval.2019.06.007 [doi]
PST - ppublish
SO  - Value Health. 2019 Oct;22(10):1119-1127. doi: 10.1016/j.jval.2019.06.007. Epub 
      2019 Aug 6.